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First Episode Psychosis (FEP): Factors associated with delayed access to care in a rural Egyptian setting

Published online by Cambridge University Press:  16 April 2020

M. El-Adl ,
M. El-Mahdy  and
M. Anis
M. El-Adl
Affiliation:
Princess Marina Hospital, Northampton, United Kingdom
M. El-Mahdy
Affiliation:
Al-Azhar University, Egypt
M. Anis
Affiliation:
Mansoura Genera Hospital, Egypt

Abstract

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Aim

To identify factors associated with delayed access of FEP to psychiatric care and possible measures that could help facilitate access and shorten duration of untreated psychosis (DUP)

Background

FEP studies show that average time between onset of symptoms & first effective treatment is often one year or more1. Long DUP is undesirable as early treatment can reduce suffering and helps minimise risk of serious consequences due to changes in mental state & behaviour2,3,4. Early results suggested that early intervention in psychosis (EIP) service is more cost effective than generic services5.

Most FEP studies have been conducted in developed countries. This study aims to address the question of FEP delayed access to care in a rural Egyptian setting.

Method

FEP cases who presented to Psychiatric Department at Mansoura General Hospital over a period of 6 months, were interviewed, together with relevant others either at first contact or after recovering from acute stage using a semistructured interview.

Main results:

  1. 1. Total cases 40: Schizophrenia 14, Affective disorders: 15, Postpartum disorders: 5 and others: 6.

  2. 2. On average FEP have first contact with Psychiatric service about 7 months from onset: Schizophrenia: 11 months and Affective within 3 months. No significant gender difference.

  3. 3. Main factors associated with delayed access to Psychiatric care:

    1. • Cultural factors (36%): Jinn “Spirit” (16%), preference to traditional healers (10%), female gender (10%).

    2. • Lack of knowledge about Mental Illness and about service (28%).

    3. • Stigma (14%)

    4. • Financial factors (14%)

    5. • Effect of Mental Illness (7.4)

    6. • Unsuitable service (0.6%)

Conclusion

Study results indicate that cultural factors, lack of knowledge about mental illness & service, stigma and financial factors may play a significant role in delayed access of FEP to care in rural areas of Egypt. Programs to improve public awareness of mental illness & available service and address stigma are likely to help.

Type
S50. Symposium: First Episode Psychosis: A Transcultural Experience
Information
European Psychiatry , Volume 22 , Issue S1: 15th AEP Congress - Abstract book - 15th AEP Congress , March 2007 , pp. S79 - S80
Copyright
Copyright © European Psychiatric Association 2007

References

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